Asthma Clinical Trial
Official title:
Effect of Inhaled Mometasone/Formoterol Versus Inhaled Fluticasone/Salmeterol on Peripheral Airway Function in Asthma Patients
The purpose of this study is to investigate the effectiveness of inhaled mometasone/formoterol versus inhaled fluticasone/salmeterol on peripheral airway function in treatment of asthma.
Peripheral airway dysfunction is associated with poor asthma outcome including asthma
exacerbation and more symptoms. The peripheral or small airway is anatomically defined by
airways with 2 mm diameter or less. Several techniques have been used for evaluating
peripheral airways such as spirometry, body plethysmography, impulse oscillometry and imaging
studies. Since inhaled corticosteroid is corner stone for treatment of asthma, the addition
of long acting beta agonist is indicated in severe asthma with poorly controlled disease
despite of high dose inhaled corticosteroid.
The inhaled corticosteroid and long acting beta agonists are available for treating asthma.
There were different results in comparison studies of different inhaled corticosteroid and
long acting beta agonist. These differences are related to type of inhaled formulation,
potency of inhaled corticosteroid or dose and outcome measurements. The previous short term
studies shown that inhaled budesonide/formoterol is superior to inhaled
fluticasone/salmeterol combination for reducing of peripheral airway resistance measured by
impulse oscillometry. However, the active drug was delivered by using dry powder inhaler.
There is no direct comparison between inhaled mometasone/formoterol and inhaled
fluticasone/salmeterol administered using metered dose inhalers. For these reasons, we
conduct the open label study comparing the effect of two inhaled corticosteroid and long
acting beta agonist in newly diagnosed asthma who are eligible for being treated with such
combination therapies.
Eligible patients who have clinically diagnosed asthma requiring treatment with combined
inhaled corticosteroid and long acting beta agonist according to Global Initiative for Asthma
(GINA) guideline. The patients will be randomized to receive either inhaled
mometasone/formoterol (100/5 microgram) 2 puffs twice daily or inhaled fluticasone/salmeterol
(125/25 microgram) 2 puffs twice daily administered using metered dose inhalers.
The primary outcome is peripheral airway function measured by airway resistance at 5 and 20
Hz frequency from impulse oscillometry. The secondary outcome are peak expiratory flow rate,
forced expiratory flow at 1 second, forced vital capacity, forced expiratory flow at 25-75%
of vital capacity (FEF25-75%) measured by spirometry, residual volume per total lung capacity
ratio measured by body plethysmography ,asthma control test score and asthma control
questionaire-7 version. All outcome are measured at baseline and 6-week post treatments in
both arms.
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